Autism:  The Personality Thief   

                                                       by.  Christine J. McQueen, RN

Spring is here and we are rejoicing in the renewal of life during this time of year.  Those of us who are avid gardeners have already planted the spring crops and are in the process of making preparations for the upcoming planting of the warm weather crops.  Those of us who have to maintain lawns are experiencing lawns that have awakened from their winter sleeping, growing very rapidly, and requiring regular cutting.  The dogwoods are blooming along with many other flowering plants.  The pollen is everywhere, on everything, aggravating those who are sensitive to it, and giving many car owners new paint jobs.  A lot of this pollen goes to fertilizing plants so that new plants are born to ensure the survival  of future generations.  The remainder of the pollen gets washed away by the spring rain showers.  This life brings circumstances, situations, and adversities that many of us would welcome the spring rains to come and wash them away.  These difficulties come in the form of parenting this generation of children, bills, health problems, and addiction just to name a few.  There are many health problems that face many of us like diabetes, hypertension, obesity, high cholesterol, asthma, kidney disease, and  fibromyalgia just to name a few.  April is national Autism month so it is only right to bring awareness and attention to this health concern.  Autism is one of the many health problems that many people and their families face each day as this disorder can rob its sufferer of the ability to properly communicate, socially interact, and behave with their loved ones. 

Autism is a complex developmental disorder of brain function that has a range of intellectual and behavioral deficits.  It occurs during infancy and early childhood from 18 to 30 months of age.  It occurs in 1 out of 88 births in the US and in 1 out of 54 boys as it is more common in males, but more females are affected severely.  The incidence of autism is not related to socioeconomic, ethnicity, or parenting style. 

The cause of autism is an unsolved and controversial question.  Those with autism may have abnormal electroencephalogram, suffer from epileptic seizures, have delayed development of hand dominance, have persistent primitive reflexes, have elevated blood serotonin, have the diagnosis of cerebellar vermal hypoplasia, have the diagnosis of fragile X syndrome, have the diagnosis of tuberous sclerosis, have the diagnosis of rubella syndrome, or suffer from untreated phenylketonuria (PKU).  There have been recent concerns that mercury-based preservatives found in many vaccines along with our children’s increased exposure to other heavy metals like mercury has caused an increase in the incidence of autism.  Research into the causes of autism continues to this day.

Children with autism have several peculiar and bizarre characteristic, mostly with social interactions, communication, and behavior.   Children with autism have a lack of or a delay in spoken language, engage in the repetitive use of language and/or motor mannerism (e.g. hand flapping, twirling objects), give little or no eye contact to others, have a lack of interest in having peer relationships, have a lack of spontaneous or make-believe play, and have a persistent fixation on parts or objects. 

Children with autism do not always have the same manifestations as mild forms of this disorder require minimal supervision by adults where as those who suffer from the severe form of this disorder (engaging in self-abuse) require maximum supervision from adults.  Most children with autism have some degree of mental retardation (MR) with intelligence quotient (IQ) scores in the moderate to severe range.  More females tend to have very low IQ scores.  Despite being moderately to severely disabled, some children with autism excel in areas of art, music, memory, math, and puzzle building and are called savants. 

Autism can be a disabling condition without early recognition of the behaviors that are associated with autism. Children with autism will engage in abnormal social play, poorly imitate others, lack the awareness of others, engage in impaired imaginative play, and have deficiencies in nonverbal and verbal communication.  Parents of young children should pay attention to the five early warning signs of autism which are:  1) no cooing or babbling by 12 month 2) no gesturing (pointing, waving, grasping) by 12 months 3) no words by 16 months 4) no two-word phrases on his or her own by 24 months 5) has any loss of language or social skills at any age.  The outcome is most favorable for children who have developed communicative speech by age 6 and have IQ scores above 50 at the time that the diagnosis is made.  There are accounts of children improving through obtaining language skills and communication with others.  Ultimate independence is obtained by some, but most will need lifelong adult supervision.   The aggravation of psychiatric symptoms occurs in about half of the children during their teens with girls having the tendency to deteriorate. 

Therapy for children with autism include providing a structured routine for the child to follow which promotes positive reinforcement, increases social awareness of others, teaches verbal communication skills, and decreases unacceptable behaviors.  Not all children with autism are the same and will require individual treatment.  Early diagnosis and early education will positively influence the child’s future development.  Children with autism have trouble with trust and will need to be introduced slowly to new situations.  Some children with autism have disturbing sleep patterns.  Some are very fussy eaters who will willfully starve themselves or gag to prevent eating or are voracious eaters who will eat anything including inedible items so adult supervision is key in keeping them safe from themselves.  They need to be told directly what to do because they have difficulty organizing their behavior and redirecting their energy.  Communication must be at the child’s developmental level, brief, and concrete.

Autism involves the entire family and oftentimes becomes a family disorder.  Parents need expert counseling early in the course of the disorder and should be referred to the Autism Society of America (ASA) which provides information about education, treatment programs, techniques, and facilities such as camps.  There is also a siblings group called SHARE (Siblings Helping Persons With Autism Through Resources and Energy).  Other helpful resources are local and state department of mental health and developmental disabilities.  As much as possible families are encouraged to care for the child in the home.  With family support programs in many states, families are oftentimes able to provide the necessary home care and assist with educational services the child needs.   So there are numerous resources and support available so that families do not have to feel isolated and abandoned as they undertake the task of caring for their loved one, oftentimes, for the rest of their lives.  For more information contact:  Autism Society of America 8601 Georgia Avenue Suite 503 Silver Spring Maryland 20910 (301) 657-0881 www.autism-society.org                                                             by. Christine J. McQueen, RN